{"doi":"10.1007/s40265-026-02329-7","title":"EGFR Exon 20 Insertion–Mutated Non-Small Cell Lung Cancer: Current Treatment Landscape and Future Directions","abstract":null,"journal":"Drugs","year":2026,"id":643374,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1674001,"name":"Noor Rashidha Binte Meera Sahib","orcid":null,"position":1,"is_corresponding":false},{"id":1674002,"name":"Carina Ysha P. Cangco","orcid":null,"position":2,"is_corresponding":false},{"id":643981,"name":"Aaron C. Tan","orcid":"0000-0001-7292-1114","position":3,"is_corresponding":false},{"id":1674000,"name":"Eunice L. Y. Lau","orcid":"0000-0003-4517-1113","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"EGFR Exon 20 Insertion–Mutated Non-Small Cell Lung Cancer: Current Treatment Landscape and Future Directions","abstract":"Epidermal growth factor receptor (EGFR) exon 20 insertions are the third most common EGFR mutation subtype in non-small cell lung cancer, occurring in up to ~4% of cases. Although the clinical profile overlaps with classical sensitizing EGFR mutations, most exon 20 insertions confer primary resistance to earlier generation epidermal growth factor receptor tyrosine kinase inhibitors, reflecting position- and variant-dependent steric constraints within the adenosine triphosphate-binding pocket. More than 100 distinct variants have been described, motivating structure- and variant-informed frameworks for diagnosis and treatment selection. Accurate detection is therefore essential: fixed-content polymerase chain reaction assays may miss clinically actionable variants, whereas next-generation sequencing improves variant capture and supports standardized reporting, including identification of co-alterations. Plasma cell-free DNA testing can complement tissue profiling when biopsy is not feasible, but low circulating tumour DNA shedding can yield false-negative results, supporting reflex tissue testing after negative plasma findings when clinical suspicion remains high. Therapeutically, the landscape has shifted rapidly since 2021, with the introduction of exon 20 insertion-directed strategies including bispecific antibodies and next-generation tyrosine kinase inhibitors, alongside an expanding pipeline of mutant-selective agents and rational combinations. Despite these advances, response durability remains limited for many patients, and both intrinsic and acquired resistance via on-target changes, bypass signalling and tumour evolution continues to drive unmet need. Future progress will likely depend on central nervous system-active strategies, adaptive sequencing guided by longitudinal molecular profiling and combination approaches that address pathway bypass and tumour heterogeneity.","is_dataset_classified":null,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"42154197","pmcid":"PMC13290872","openalex_id":"https://openalex.org/W7161632201","authors":[],"funders":[],"total_grants":0,"fwci":6.6656,"citation_percentile":0.96701691,"influential_citations":0,"citation_trend":[{"year":2026,"count":1}],"oa_status":"hybrid","license":"cc-by-nc","oa_locations":[{"url":"https://doi.org/10.1007/s40265-026-02329-7","host_type":"journal"},{"url":"https://doi.org/10.1007/s40265-026-02329-7","host_type":"publisher"},{"url":"https://link.springer.com/content/pdf/10.1007/s40265-026-02329-7.pdf","host_type":"publisher"},{"url":"https://link.springer.com/article/10.1007/s40265-026-02329-7","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/42154197","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13290872/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13290872","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC13290872?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Lung Cancer Treatments and Mutations","Cancer Immunotherapy and Biomarkers","Lung Cancer Diagnosis and Treatment","Humans","Carcinoma, Non-Small-Cell Lung","Lung Neoplasms","ErbB Receptors","Exons","Protein Kinase Inhibitors","Mutation","Antineoplastic Agents","Drug Resistance, Neoplasm","Mutagenesis, Insertional"],"mesh_terms":["Antineoplastic Agents","Carcinoma, Non-Small-Cell Lung","Exons","Humans","Lung Neoplasms","Mutation","Mutagenesis, Insertional","Drug Resistance, Neoplasm","Protein Kinase Inhibitors","ErbB Receptors"],"keywords":["Epidermal growth factor receptor","Exon","Tyrosine kinase","Tyrosine-kinase inhibitor","Targeted therapy","Receptor tyrosine kinase","Liquid biopsy","Companion diagnostic"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"},{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-08T16:18:03.357629Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}